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Apremilast attenuates hepatic steatosis and metabolic dysfunction in a murine model of MASLD: Implications for patients with Psoriatic disease

Biomedicine & Pharmacotherapy, 2025

Ruiz-Ponce M., Rodriguez-Cuenca S., Martin-Salazar J., Pérez-Sánchez C., Martínez-Moreno J., Llamas-Urbano A., Campbell M., Romero-Zurita L., López-Montilla M., Cuesta-López L., Barranco A., Ortiz-Buitrago P., López-Pedrera C., Escudero-Contreras A., Collantes-Estevez E., López-Medina C., Vidal-Puig A., Arias-de la Rosa I., Barbarroja N.

Disease areaApplication areaSample typeProducts
Metabolic Diseases
Hepatology
Pathophysiology
Mouse Tissue Lysate
Mouse Serum
Olink Target 96 Mouse

Olink Target 96 Mouse

Abstract

Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of morbidity, linked to obesity, type 2 diabetes, and cardiovascular disease. Psoriatic disease (PsD), a chronic inflammatory condition, often coexists with MASLD, exacerbating systemic inflammation and cardiometabolic risk. Apremilast, a selective PDE4 inhibitor approved for PsD, may provide additional metabolic benefits by improving weight, lipid metabolism, and insulin sensitivity.
Objective
To evaluate the effects of apremilast on metabolic dysfunction, hepatic steatosis, and systemic inflammation in PsD patients with metabolic comorbidities, and to investigate mechanistic impact in a murine model of diet-induced MASLD.
Methods
Twenty PsD patients treated with apremilast were stratified by metabolic comorbidities. Glucose metabolism and liver function were monitored for 6 months. In parallel, C57BL/6 J mice were fed chow or GAN diet. After 14 weeks, apremilast (10 mg/kg/day) was administered for two weeks. Body weight, adiposity, liver biomarkers, insulin resistance, histology, and proteomics were evaluated.
Results
In PsD patients with comorbidities, apremilast reduced fasting insulin, HOMA-IR, transaminases, and the hepatic steatosis index. GAN-fed mice developed steatosis, increased fat mass, and elevated alanine aminotransferase (ALT) and HOMA-IR levels. Apremilast reduced body weight, ALT, insulin resistance, and hepatic fat. Histology confirmed a decrease in fibrosis. Proteomic profiling showed modulation of inflammatory, fibrotic, and lipid metabolic pathways, partially reversing GAN-induced proinflammatory signatures in liver, adipose tissue, and muscle.
Conclusions
Apremilast ameliorates hepatic dysfunction, improves insulin sensitivity, and reduces systemic metabolic dysfunction in a murine MASLD model. These findings support its therapeutic potential in PsD patients with metabolic disease, offering both anti-inflammatory and metabolic benefits.

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